Assisted Living Case Study: A Fresh Start

By Anne Cosgrove
Published in the January 2007 issue of Today’s Facility Manager

When Jennifer Stratton learned of a facility management position available at Home Harbor of Racine, it was like a dream come true. Having worked with senior populations for more than a decade—much of the time in the Racine, WI area—Stratton knew there was a demand for affordable assisted living options for senior citizens, and she wanted to contribute to providing a solution.

Now, as facility director at Home Harbor, she has the opportunity to ensure the daily satisfaction of the facility’s 98 residents. “I feel connected to the seniors in Racine, because I’ve been working with them for so long,” Stratton explains. “And Home Harbor offers just what area seniors are searching for.”

Kevin Kadlec, an owner in the facility and president of KMK Construction in Milwaukee, WI, discovered the building in late 2003 after a friend advised he consider purchasing it and renovating it to become an assisted living facility for senior citizens. Kadlec took an afternoon to visit the facility, which was operating as a 400 bed nursing home with 60 residents, and surrounding area to assess the potential of the project.

This required imagination on his part, since the nursing home was not only drab, but it was also in a general state of disrepair. The original portion of the 78,000 square foot structure had been built in the mid-1960s, with multiple additions in subsequent years. The focus had been on functionality rather than aesthetics.

Despite its dilapidated condition, the facility prompted Kadlec to pursue a renovation. Under the heading, KAB Racine Properties, L.P, he partnered with two other parties to purchase the site. “I was pretty sold on the facility once I took a tour,” he recalls. “There was a great need for affordable assisted living in the community, and the building itself was well located relative to amenities for seniors.”

In order to be able to offer residents of the new facility affordable living options, Kadlec decided to pursue Section 42 Tax Credits through the Wisconsin Housing and Economic Development Authority (WHEDA). Established in 1988, the Section 42 program aims to make a development project more affordable for the owner through a system of credits paid out over a 15-year period. Kadlec hired Southwest Design Associates, Inc. of Platteville, WI, an architectural firm experienced in Section 42 projects. Says Southwest President Richard Adams, “We had worked on projects in the past with [Kadlec], though this was the first involving Section 42.”

Transforming The Building

At the top of the list was to eradicate the institutional atmosphere of the facility that had existed while the building operated as a nursing home. Most of the interior walls were painted cinder block, precast concrete ceilings were unfinished, and windows were at a minimum.

The goal was to create a comfortable atmosphere for future residents, and Kadlec and Adams set to work to achieve this. During this time, the nursing home residents moved out of the facility.

“At least 20 different designs were considered,” says Kadlec. “The winning one was chosen due to the best use of the existing floor plan and its ‘homelike’ environment.”

The exterior renovation included adding a pitched roof, updating the windows, and providing each unit with an accessible patio.

A total of 86 units—10 studios, 65 one-bedrooms, and 11 two-bedrooms—were planned for Home Harbor. “The existing rooms were small, so the plan was to demolish walls until we had the desired configuration of units,” explains Adams.

In planning the layout for the renovation, Kadlec notes that one option discussed was to increase the size of units by approximately 120 square feet. “We could accomplish this by adding ‘bumps’ on the exterior. However, it was not cost-effective, and since the units would be larger than average already, we didn’t proceed that way.”

“With the interior, the overall issues were to determine how large the units would be and what amenities would be included,” explains Adams. “Quite a bit of that was dictated by the Section 42 program, because it is a scoring competitive application. In order to obtain points toward approval, we had to provide unit and site amenities. For example, if we put an air conditioning in the unit, we received a point. An emergency call system earned another point.”

The resulting units feature contemporary and clean design. “The kitchens have standard appliances and wood laminate floors,” describes Adams. “The living room and dining areas are carpeted. All the units are handicapped accessible, including roll-in showers in the bathrooms.”

Demolition and construction took 18 months to complete, much of which was spent on the demolition aspect. “The entire building is constructed of reinforced concrete and reinforced concrete block,” explains Kadlec. “Aside from interior walls that needed to be knocked down, a major challenge was that the plumbing system was located under a slab on grade floor.” Since the units were being reconfigured from the existing rooms, the plumbing fixtures had to be relocated.

All other building systems were replaced as well. “In addition to the plumbing system, all new electrical and heating and ventilation systems were installed,” says Adams. “Virtually the only system that remains from before the restoration is the elevator. We kept that core in the same location.”

Fostering Community

The transformation continued right through the entire building into common areas. The dull lobby was redesigned into a warm and welcoming reception space. A baby grand piano is the centerpiece of the lobby, which features carpeting, comfortable furniture, and ambient lighting. This area shares the space with the front reception desk.

The facility’s long hallways—some up to 200’—were an aesthetic concern. The cinder block walls were removed and replaced.

From there, the design team sought to break up the long stretches. Recalls Adams, “We addressed this issue by placing nurses’ stations at points along the hallways. We also incorporated a cascading waterfall in one place to soften up the space.”

Commenting on the waterfall, Stratton notes that elements of nature are often used in senior living environments. “The sound of it is very relaxing. Residents and visitors are drawn to the water feature, which presently houses two fish.”

Additional common areas, collectively referred to as Harbor Pointe, are located toward the back of the facility.

A main component of the area is the expanded dining room, which underwent a complete transformation. “We raised the ceiling in the dining room by 6′,” says Adams. “And Kevin chose to install decorative ceiling panels and chandeliers. Furthermore, there were only a few small windows in there, and we put in large windows around the entire room. It totally changed the feeling.”

In the Harbor Pointe area, a “town square” was created with the addition of a coffee shop, a hair salon, a laundromat, a bank, a post office, and a convenience store. This open area is furnished with small tables and several benches where residents can socialize.

In another section of the facility, there is a library/reading room and a card and puzzle corner.

Moving In

When Stratton joined the project team in September 2005, the major construction had just begun. “It was in the raw construction stage at that point,” she recalls. “The inside of the building was gutted, and the team was in the process of replacing the roof.

The “town square” area provides residents with a place to gather throughout the day. Shown here, the coffee corner is furnished with contemporary and comfortable tables and chairs.

In January 2006, Stratton and her assistant set up an office in an empty unit to coordinate the phased move-in of occupants. The first 14 units were completed in March 2006. Stratton recalls this first phase of moving residents into the facility: “There were three phases to opening. One of the challenges of doing this in phases was that common areas were very limited until the second phase was open; much of that space is in the part of the facility containing the phase two units.”

However, Stratton points out the phased opening had advantages in that she and her staff were able to “work out any kinks” that occurred in an earlier phase in order to avoid the same problems in the next phase.

Personalized Service

The amount of assistance required by the residents of Home Harbor varies from virtually none to up to 28 hours per week of personal care. Within that spectrum, programs are as different as each individual resident.

Stratton explains the “a la carte” structure that exists. “It runs the gamut. Some residents just need a little help—perhaps a meal each day or assistance with medication. When a resident moves in, we do an assessment to determine what services are wanted and needed, and the resident will pay for those items specifically.” For those who need more of a full care program, the facility charges a flat rate for comprehensive coverage.

This pay as you go structure also applies to the amenities offered at Home Harbor. These include beauty salon and barber services, massages, social and recreational programs, housekeeping and laundry services, and convenience store purchases.

Residents can also purchase a single meal whenever they’d like. Stratton notes this has been popular during special events. “Recently, we had 100 people attend a holiday dinner. On a regular evening, there are usually about 40 for dinner. We billed the additional attendees for just that one meal.”

Respect for each resident’s privacy is a basic goal at Home Harbor, and the variety of care options is focused on that target. However, one area that Stratton notes they put a collective focus on is the safety and security of residents.

“The one thing we highly recommend for each resident is that they wear a Security Escort bracelet or necklace, which has a call button on it,” says Stratton. “If a person needs help, s/he pushes the button, and a signal is sent to the nurse’s station and to staff pagers. The computer system tells staff members who and where the occupant is.”

Stratton notes that, while they cannot require residents to wear the Security Escort identifier, it is strongly recommended. “The system is multipurpose,” she notes. “It tells us when an occupant needs help, but it also helps to keep safe those who have early stages of Alzheimer’s or dementia. If one such resident leaves his or her apartment, the system has the ability to alert us at the nurse’s station, and we can see if the resident is accompanied. If not, we know to check on the person immediately.”

Protecting residents from intruders is addressed with a combination of access control and surveillance. Upon entering the outer foyer of the facility, people must swipe their key cards to proceed further. Those without a card use the intercom system to call the front desk or resident they intend to visit. An in-house television channel allows residents to view who is in the foyer before letting the visitor into the building.

Additionally, Stratton and her staff are able to keep an eye on all of the public spaces in the facility with a network of security cameras.

“Security was of paramount concern, and incredible attention was paid to this aspect,” Kadlec says. “The use of technology was instrumental in making the facility profitable due to labor being the largest expense.”

Making A Difference

The impact that Home Harbor has made on the community is clear. Not only has the facility improved the appearance of the landscape, but, more importantly, it has added to the options for senior citizens in the area.

“My satisfaction lies in the fact that the facility helps to provide affordable assisted living for those who need it most,” says Kadlec. “The comments we’ve received on Home Harbor note the vast changes from the previous facility.”

During a recent holiday open house tour, a woman who had worked in the building for 17 years while it was a nursing home was amazed at the changes. “She would lose her bearings,” recalls Stratton, “saying, ‘I never dreamt I would not know where I was in this building.”

Combined knowledge and a shared vision enabled the team at Home Harbor to succeed in bringing a state of the art assisted living facility to Racine, WI. Now, residents of the facility and the community as a whole can benefit from their hard work.

This article was based on interviews with Adams (steve@swdesign.com), Kadlec (kevin@kmkconst.com), and Stratton (jennifers@homeharbor.com).

Project Information:

Project: Home Harbor of Racine. Location: Racine, WI. Type of Project: Major renovation of existing facility. Function: Senior Assisted Living. Owner: KAB Racine Properties, L.P. Developer: Kevin Kadlec. Project Management Team (in house): Jennifer Stratton for Senior Living Strategies. Square Footage: 106,000. Funding Provider: Valley Bank. Budget: $8 million (construction). Construction Timetable: 2003 to August 2006. Cost Per Square Foot: $75.47. Architect: Southwest Design Associates, Inc. Electrical Engineer: Kadlec Electric. General Contractor/Construction Manager: Craig Needham. Lighting Designer: Midwest Lighting. Interior Designer: Tim Mellentine.

Product Information:

Furniture: HON; Room Solutions; Riverside; Southern Motion; Carolina Furniture Works; Symbol Mattresses. Wall Coverings/Paint: Sherwin-Williams. Ceilings: Acoustic Ceiling Products; USG. Light Fixtures: White Westinghouse; SIMKAR Corp.; Quorum Int’l.; Capital; Lithonia Lighting. Acoustics/Sound Masking: CPI. Window Treatments: Sunteca. Rest Room Fixtures: American Standard; Mansfield. Storage Equipment: Rubbermaid. Security System: Security Escort; Notifier. CCTV: Pelco. Door Locks: TEI Manufacturing. Smart Cards/ID Badging: HID. Safety Equipment/Alarms/Sensors: Notifier. HVAC Equipment: Comfort-Aire. Building Management System/Services: PALS System. Power Supply Equipment: Cutler Hammer. Roofing System: UBC. Exit Signs: SIMKAR Corp. Network Equipment/IT Infrastructure: Peak Resource Group (consultants). Wiring: Kadlec Electric. Rest Room Equipment/Supplies: Zep Manufacturing. Windows/Glazing: Badger Custom Windows. Elevators: Saeflite Elevator Company.